Physician
Palmetto Health
Palmetto Health was paid $597K by Medicaid between Jan 2018 and Nov 2018, across 30 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 56% of everything it billed.
33Billing provider infoPALMETTO HEALTH
SUMTER, SC 29150
SUMTER, SC 29150
33aNPI1710342787assigned 12/17/2015
33bProvider typeObstetrics & Gynecology Physician
28Total paid$597K
24GClaims18,365
24DCodes billed30
24AFirst – last monthJan 2018 – Nov 2018
Compared with peers
Next to other Obstetrics & Gynecology Physician providers in South Carolina
Rank by total paid#37 of 206
Median peer was paid$10K
This provider vs. median60×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official COVEN, DARRELL controls 12+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 18,365 | $597K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 56% | 6,158 | 5,577 | $332K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 22% | 3,815 | 1,560 | $129K |
| 99223 | Prolong inpt eval add15 m | 7.2% | 420 | 418 | $43K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.7% | 306 | 302 | $16K |
| 85018 | 1.5% | 3,048 | 2,969 | $9K | |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 1.2% | 135 | 61 | $7K |
| 59025 | Fetal non-stress test | 1.2% | 249 | 184 | $7K |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | 1.2% | 111 | 108 | $7K |
| 81025 | 1.0% | 798 | 757 | $6K | |
| 99239 | Hospital discharge day management, more than 30 minutes | 1.0% | 124 | 124 | $6K |
| 20610 | <1% | 279 | 249 | $5K | |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 37 | 37 | $4K |
18 more codes
| 36415 | Collection of venous blood by venipuncture | <1% | 1,296 | $3K |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 43 | $3K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 263 | $3K |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 50 | $3K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 230 | $2K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 15 | $2K |
| 90686 | <1% | 94 | $1K | |
| 76830 | Ultrasound, transvaginal | <1% | 15 | $1K |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 249 | $938.77 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 208 | $856.13 |
| 99220 | <1% | 12 | $854.62 | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 249 | $799.73 |
| H0002 | Behavioral health screening to determine eligibility for admission to treatment program | <1% | 32 | $654.71 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 25 | $539.94 |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 64 | $491.33 |
| 90715 | <1% | 12 | $439.21 | |
| 62323 | <1% | 12 | $271.56 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 16 | $270.37 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialCOVEN, DARRELL (DIRECTOR, BUS FINANCE)
Parent organizationPALMETTO HEALTH
| Provider | Location | Paid |
|---|---|---|
| Palmetto Health | Columbia, SC | $154K |
| Palmetto Health | Columbia, SC | $114K |
| Palmetto Health | Columbia, SC | $93K |
| Palmetto Health | Columbia, SC | $80K |
| Palmetto Health | Columbia, SC | $15K |
| Palmetto Health | Columbia, SC | $10K |
| Palmetto Health | Columbia, SC | $5K |
| Palmetto Health | Columbia, SC | $4K |
| Palmetto Health | Columbia, SC | $4K |
| Palmetto Health | Columbia, SC | $3K |
| Palmetto Health | Columbia, SC | $1K |
| Palmetto Health | Columbia, SC | $708.59 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.